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Approve Pandemic Forms

State Approver users can approve pandemic forms for providers that have enrolled in the Pandemic Vaccine Provider program. The Administration > Settings > Properties > Vaccine Management > Enable Pandemic Provider Agreement Features and Allow Providers to fill out Pandemic Enrollment Forms (and, optionally, All Providers to sign Pandemic Provider Agreement) options must be enabled.

To approve pandemic forms, click the Orders/Transfers > Approve Pandemic Forms menu link. The Pandemic Forms Search page opens. Select or enter the search criteria and click Search.

The available search criteria fields on this page include:

Field Description

Organization (IRMS) Name

To limit the list to a specific Organization (IRMS), select it from the drop-down list.

Facility Name

To limit the list to a specific Facility, select it from the drop-down list.

Enrollment Status

To limit the list to a specific enrollment status, select it from the drop-down list.

Agreement Status

To limit the list to a specific agreement status, select it from the drop-down list.

Submit Date Range

To limit the list to pandemic forms submitted within a specific date range, enter the From and Through dates.

PIN

To limit the list to a specific PIN range, select the From and Through PIN numbers from the drop-down lists.

Phone Number

To limit the list to a specific phone number, enter it in the field.

Fax Number

To limit the list to a specific fax number, enter it in the field.

Email

To limit the list to a specific email address, enter it in the field.

The search results appear in two sections on the page: Pandemic Provider Enrollment Search Results, containing a list of available pandemic forms, and the Pandemic Provider Agreement Search Results section, listing the available pandemic provider agreements.

The columns and buttons in the Pandemic Provider Enrollment Search Results section are as follows:

Column/Button Description

Select

Click the arrow button in the Select column to open the Online Pandemic Influenza Registration Request page/form for that provider. See Pandemic Provider Registration.

Facility Name

The name of the provider facility.

Enrollment Status

The provider's current enrollment status.

Date

The date the enrollment form was submitted.

Approval Date

The date the enrollment form was approved, if applicable.

Expiration Date

The date the enrollment form is set to expire, if applicable.

Delete

Click this button to delete the pandemic provider enrollment form. Use caution, as this action is not reversible.

The columns, buttons, and links in the Pandemic Provider Agreement Search Results section are as follows:

Field Description

Select

Click the arrow button in the Select column to open the pandemic provider agreement.

PDF-Full

Click the link in this column to open a PDF version of the complete pandemic provider agreement.

Facility Name

The name of the provider facility.

Approval Status

The provider agreement's current approval status.

Date

The date the pandemic provider agreement was submitted.

Approval Date

The date the pandemic provider agreement was approved, if applicable.

Expiration Date

The date the pandemic provider agreement is set to expire, if applicable.

Delete

Click this button to delete the pandemic provider agreement. Use caution, as this action is not reversible.
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